Our Summary

This paper discusses a rare heart condition called a left ventricular pseudoaneurysm, which can occur after a certain type of heart infection called infective endocarditis. This condition can lead to serious heart problems like cardiac tamponade (pressure on the heart due to fluid build-up), rupture, and repeated heart infections. The authors share the case of a 48-year-old woman who underwent a specific heart surgery for active infective endocarditis. Two weeks after the surgery, the woman was found to have a left ventricular pseudoaneurysm. The doctors were able to repair this through a minimally invasive surgery involving a small incision in the left side of the chest and the use of an endoscope (a flexible tube with a camera on the end). The woman recovered well after the surgery and did not experience a recurrence of the condition 18 months later. The research suggests that this minimally invasive approach may be an effective way to treat left ventricular pseudoaneurysm.

FAQs

  1. What is a left ventricular pseudoaneurysm and how does it relate to infective endocarditis?
  2. How is a left ventricular pseudoaneurysm repaired after endoscopic mitral valve repair?
  3. What potential complications can arise from a left ventricular pseudoaneurysm?

Doctor’s Tip

One helpful tip a doctor might tell a patient about mitral valve repair is to follow a healthy lifestyle, including regular exercise and a balanced diet, to help improve heart health and reduce the risk of complications. It is also important to attend regular follow-up appointments with your healthcare provider to monitor your heart health and ensure the success of the mitral valve repair procedure.

Suitable For

Patients who are typically recommended for mitral valve repair are those who have mitral valve regurgitation or stenosis due to conditions such as mitral valve prolapse, rheumatic heart disease, or infective endocarditis. In the case of infective endocarditis, mitral valve repair may be recommended to prevent further complications such as left ventricular pseudoaneurysm. Patients who are otherwise healthy and have good overall heart function are usually considered good candidates for mitral valve repair.

Timeline

Before Mitral Valve Repair:

  • Patient presents with symptoms of infective endocarditis, such as fever, fatigue, and heart murmur
  • Diagnosis of infective endocarditis is confirmed through imaging tests, blood cultures, and echocardiogram
  • Mitral valve repair surgery is recommended to treat the infective endocarditis and prevent further complications

After Mitral Valve Repair:

  • Patient undergoes endoscopic mitral valve repair surgery to remove infected tissue from the valve
  • Left ventricular pseudoaneurysm is discovered 2 weeks after the surgery
  • Patient undergoes a left thoracotomy with a totally endoscopic platform to repair the pseudoaneurysm
  • Postoperative course is uneventful, with no recurrence of the pseudoaneurysm at 18 months
  • Patient is monitored for any signs of recurrent infective endocarditis or other complications

Overall, the patient experiences a series of diagnostic tests, surgical procedures, and postoperative monitoring before and after mitral valve repair to address infective endocarditis and its complications.

What to Ask Your Doctor

  1. What is a left ventricular pseudoaneurysm and how does it relate to my mitral valve repair surgery?
  2. What are the potential complications associated with a left ventricular pseudoaneurysm?
  3. How will the pseudoaneurysm be repaired and what is the expected outcome?
  4. What is the recovery process like after surgery to repair a left ventricular pseudoaneurysm?
  5. Are there any long-term implications or considerations I should be aware of following the repair of the pseudoaneurysm?
  6. How often will I need to follow up with my doctor after the surgery?
  7. Are there any lifestyle changes or precautions I should take to prevent future complications?

Reference

Authors: Kajiyama K, Hosoba S, Kato R, Ito T. Journal: Eur J Cardiothorac Surg. 2023 May 2;63(5):ezad202. doi: 10.1093/ejcts/ezad202. PMID: 37202353